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Diagnostic accuracy of 18F-FDG PET/CT for assessing response to radiofrequency ablation treatment in lung metastases: a multicentre prospective study

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

To assess diagnostic accuracy of 18F-FDG PET/CT at 3 months for the detection of local recurrence after radiofrequency ablation (RFA) of lung metastases.

Methods

The PET/CT scan at 3 months was compared with a baseline PET/CT scan from a maximum of 2 months before RFA, with the reference standard as recurrence diagnosed by CT during a 12-month follow-up. Local recurrence was diagnosed on the PET/CT scan if lesional uptake was greater than the mediastinal background. Maximum standardized uptake values (SUVmax) were recorded. ROC curve analysis for SUVmax was performed. Overall survival (OS) and time to local relapse were computed from the date of RFA using the Kaplan-Meier method (www.clinicaltrials.gov: NCT 00382252).

Results

Between 2005 and 2009, 89 patients (mean age 65 years) underwent RFA for 115 lung metastases (mean size 16.2 ± 6.9 mm). The median SUVmax before RFA was 5.8 ± 4. PET/CT at 3 months and the reference standard were available in 77 patients and 100 lesions. Accuracy was 66.00 % (95 % CI 55.85–75.18 %), sensitivity 90.91 % (95 % CI 58.72–99.77 %), specificity 62.92 % (95 % CI 52.03–72.93 %), PPV 23.26 % (95 % CI 11.76–38.63 %), and NPV 98.25 % (95 % CI 90.61–99.96 %). One-year OS was 94.2 % (95 % CI 86.6–97.5 %) and the probability of being free of local recurrence 1 year after RFA was 84.6 % (95 % CI 75.0–90.8 %).

Conclusion

The specificity of PET/CT at 3 months is low because of persistent inflammation, especially when the lesion is close to the pleura. This technique is useful for its negative predictive value, but positive findings need to be confirmed by histology before new treatment is planned.

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Acknowledgments

The authors would like to thank the French Ministry of Health for financial support, Béatrice Gonzales for data collection and control and Pippa McKelvie-Sebileau of Institut Bergonié for assistance with medical writing.

Disclosures

The authors have no disclosures to declare.

Funding source

This work was supported by a PHRC 2006 (Programme Hospitalier de Recherche Clinique) of the French Ministry of Health.

Prior presentations

This work was presented at the Society of Nuclear Medicine Annual Meeting, San Antonio, June 2011, and the Cardiovascular and Interventional Radiological Society of Europe Annual Meeting, Munich, September 2011.

Author information

Authors and Affiliations

  1. Department of Nuclear Medicine, Institut Bergonié, 229 cours de l’Argonne, 33076, Bordeaux, France

    Françoise Bonichon, Yann Godbert & Anne-Laure Cazeau

  2. Department of Interventional Radiology, Institut Bergonié, Bordeaux, France

    Jean Palussière & Edouard Descat

  3. Unit of Clinical Epidemiology and Clinical Research, Institut Bergonié, Bordeaux, France

    Marina Pulido

  4. Cancer Trial Data Center, INCa, Bordeaux (Centre de Traitement des Données de Bordeaux, Institut National du Cancer), Bordeaux, France

    Marina Pulido

  5. Department of Nuclear Medicine, Eugène Marquis Anticancer Centre, Rennes, France

    Anne Devillers

  6. Department of Radiology, Centre Hospitalier Universitaire, Rennes, France

    Catherine Meunier

  7. Department of Nuclear Medicine and Endocrine Oncology, Institut Gustave Roussy, University Paris Sud, Villejuif, France

    Sophie Leboulleux

  8. Department of Interventional Radiology, Institut Gustave Roussy, Villejuif, France

    Thierry de Baère

  9. Department of Nuclear Medicine, Centre Hospitalier de la Côte Basque, Bayonne, France

    Claire Galy-Lacour

  10. Department of Medical Imaging, Centre Hospitalier de la Côte Basque, Bayonne, France

    Laurent Lagoarde-Segot

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  1. Françoise Bonichon
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  12. Anne-Laure Cazeau
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Corresponding author

Correspondence to Françoise Bonichon.

Additional information

The reference of the study according to the international clinical trials base CLINTRIAL (www.clinicaltrials.gov) is NCT 00382252.

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Bonichon, F., Palussière, J., Godbert, Y. et al. Diagnostic accuracy of 18F-FDG PET/CT for assessing response to radiofrequency ablation treatment in lung metastases: a multicentre prospective study. Eur J Nucl Med Mol Imaging 40, 1817–1827 (2013). https://doi.org/10.1007/s00259-013-2521-9

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  • DOI: https://doi.org/10.1007/s00259-013-2521-9

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